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Wu D, Lan X, Litscher G, Zhao YL, Wu YQ, Dai RJ, Cao K, Wang Y, Chen LQ. Laser acupuncture and photobiomodulation therapy in Bell's palsy with a duration of greater than 8 weeks: a randomized controlled trial. Lasers Med Sci 2024; 39:29. [PMID: 38216803 PMCID: PMC10787006 DOI: 10.1007/s10103-023-03970-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 12/28/2023] [Indexed: 01/14/2024]
Abstract
To investigate the efficacy of laser acupuncture and photobiomodulation therapy in alleviating symptoms among patients diagnosed with Bell's palsy with duration of greater than 8 weeks. The randomized controlled trial has been performed from May 2021 to April 2023. Patients were eligible who had Bell's palsy with duration of greater than 8 weeks on out-patient Department of Otorhinolaryngology in Beijing Tongren Hospital. The laser acupuncture group received class IV laser treatment for 3 times per weeks, a total of 72 times. The control group received the same treatment procedure except the laser parameter. The primary outcome measures comprised House-Brackmann facial nerve grading system and electroneurography. Secondary outcome measures comprised Sunnybrook facial grading system, electromyography, and the blink reflex. A total of 84 participants were included (42 control group, 42 laser acupuncture group). After treatment, House-Brackmann facial nerve grading system (OR, 0.11; 95% CI, 0.04-0.30; P < 0.001), and the pathologic numbers of electroneuronography were statistically different between the laser acupuncture group and control group, including orbicularis oculi (OR,0.08; 95% CI, 0.02-0.21; P < 0.001), Frontalis muscle (OR,0.14; 95% CI, 0.05-0.39; P < 0.001), Orbicularis oris (OR,0.13; 95% CI, 0.04-0.36; P < 0.001), Ala nasi muscle (OR,0.06; 95% CI, 0.02-0.18; P < 0.001). In secondary outcomes, Sunnybrook facial grading system, has significant difference between the two groups (20.26; 95% CI, 14.69 to 25.83; P < 0.01). Latency by ENoG, include orbicularis oculi (-0.61; 95% CI, -0.43 to -0.09; P < 0.001), frontalis muscle (-0.12; 95% CI, -0.21 to -0.03; P < 0.01), orbicularis oris (-0.28; 95% CI, -0.41 to -0.16; P < 0.001), and ala nasi muscle (-0.26; 95% CI, -0.38 to -0.16; P < 0.001). All amplitudes of MUAPs and durations by electromyography (EMG) showed statistically significant differences compared with the control group after treatment. For the frontalis muscle, the amplitude of MUAPs was -64.23 (95% CI, -80.89 to -47.56; P < 0.001) and duration was -1.18 (95% CI, -1.49 to -0.87; P < 0.001). For orbicularis oris, amplitude of MUAPs was -29.82 (95% CI, -55.03 to -4.62; P = 0.02) and duration was -0.57 (95% CI, -0.94 to -0.20; P < 0.001). For depressor angulli oris, amplitude of MUAPs was -47.06 (95% CI, -62.15 to -31.97; P < 0.001) and duration was -2.21 (95% CI, -2.69 to -1.72; P < 0.001). Blink reflex, including R1 (OR, 0.03; 95% CI, 0.01-0.16; P < .001), R2 (OR, 0.04; 95% CI, 0.004-0.29; P < .001), and R2 latency differences (OR, 0.15; 95% CI, 0.05-0.51; P < .001), have significant difference between the two groups, respectively. The findings suggest that laser acupuncture relieve symptoms for patients with Bell's palsy with a duration of greater than 8 weeks.Trial registration: ClinicalTrials.gov Identifier: NCT05846217.
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Affiliation(s)
- Dong Wu
- Department of Traditional Chinese Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China
| | - Xin Lan
- Jococo Inc, Los Angeles, CA, USA
| | - Gerhard Litscher
- President of the International Society for Medical Laser Applications (ISLA transcontinental; since 2012), German Vice President of the German-Chinese Research Foundation (DCFG) for TCM (since 2014), Vice Chairperson, World Federation of Chinese Medicine Societies, Committee of Card. Rehab. (2023-2028), Honorary President of the European Federation of Acupuncture and Moxibustion Societies (2023), Honorary Professor of China Beijing International Acupuncture Training Center, China Academy of Chinese Medical Sciences (2023), Former Head of two Research Units at Medical University of Graz, 8036, Graz, Austria
| | - Yan-Ling Zhao
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yun-Qing Wu
- Department of Neurology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ru-Jun Dai
- TED Healthcare Technology Ltd (Beijing), Beijing, China
| | - Kai Cao
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yu Wang
- Institute of Acupuncture-Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Lu-Quan Chen
- Department of Traditional Chinese Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China.
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Wu D, Zhao YL, Sun JY, Dai RJ, Cao K, Qu RK, Wang Y, Wu YQ. A Nonrandomized Trial of the Effects of Near-Infrared Photobiomodulation Therapy on Bell's Palsy with a Duration of Greater Than 8 Weeks. Photobiomodul Photomed Laser Surg 2023; 41:490-500. [PMID: 37738368 DOI: 10.1089/photob.2023.0056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/24/2023] Open
Abstract
Objective: To determine whether photobiomodulation therapy (PBMT) by class IV Multiwave Locked System laser treatment as an adjunctive therapy could relieve symptoms in patients with Bell's palsy with a duration of greater than 8 weeks. Materials and methods: This nonrandomized controlled trial was conducted from January 2020 to December 2022. Patients were eligible if they had Bell's palsy with a duration of greater than 8 weeks at the out-patient department of otorhinolaryngology in Beijing Tongren Hospital. The control group consisted of patients recruited between January 1, 2020, and December 31, 2020. The PBMT group consisted of patients recruited between January 1, 2021, and December 31, 2022. In this study, the PBM used has a wavelength of 808 and 905 nm, 1.2 W power (808 nm is 1 W, 905 nm is 200 mW), continuous mode emission (808 nm) and pulsed mode emission (905 nm), 8.35 J/cm2 dosimetry, administered 3 times per week, 72 times of total treatment. The primary outcome measures included the House-Brackmann facial nerve grading system, the Sunnybrook facial grading system, and the Facial Clinimetric Evaluation Scale (FaCE). Secondary outcome measures comprised electroneurography, electromyography, and the blink reflex. Results: A total of 54 participants were included (27 in the control group and 27 in the photobiomodulation group). After 6 months, the House-Brackmann grading system [risk difference, -0.59, confidence interval (95% CI), -0.81 to -0.38, relative risk, 0.27, 95% CI, 0.13-0.56, p < 0.001], Sunnybrook facial grading system (21.14, 95% CI, 11.71-30.58; p < 0.001), and FaCE (-0.20, 95% CI, 0.41-0.02; p = 0.07) had significant difference between the two groups. Latency of ala nasi muscle (10.92, 95% CI, 5.58-16.27; p < 0.001) was not statistically significant after treatment compared with the control group; however, most of the electrophysiological examinations have significant difference between the two groups, respectively. Conclusions: The results of this study suggest that PBMT may relieve symptoms for patients with Bell's palsy with a duration of greater than 8 weeks. Trial Registration: ClinicalTrials.gov Identifier: NCT05585333.
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Affiliation(s)
- Dong Wu
- Department of Traditional Chinese Medicine and Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yan-Ling Zhao
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jing-Yi Sun
- Department of Oncology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Ru-Jun Dai
- TED Healthcare Technology Ltd (Beijing), Beijing, China
| | - Kai Cao
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Rong-Kun Qu
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yu Wang
- Institute of Acupuncture-Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yun-Qing Wu
- Department of Neurology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
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Ordahan B, Karahan AY. Role of low-level laser therapy added to facial expression exercises in patients with idiopathic facial (Bell's) palsy. Lasers Med Sci 2017; 32:931-936. [PMID: 28337563 DOI: 10.1007/s10103-017-2195-9] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2016] [Accepted: 03/14/2017] [Indexed: 11/25/2022]
Abstract
The aim of the present study was to investigate the efficacy of low-level laser therapy in conjunction with conventional facial exercise treatment on functional outcomes during the early recovery period in patients with facial paralysis. Forty-six patients (mean age 41 ± 9.7 years; 40 women and 6 men) were randomized into two groups. Patients in the first group received low-level laser treatment as well as facial exercise treatment, while patients in the second group participated in facial exercise intervention alone. Laser treatment was administered at a wavelength of 830 nm, output power of 100 Mw, and frequency of 1 KHz using a gallium-aluminum-arsenide (GaAIAs, infrared laser) diode laser. A mean energy density of 10 J/cm2 was administered to eight points of the affected side of the face three times per week, for a total of 6 weeks. The rate of facial improvement was evaluated using the facial disability index (FDI) before, 3 weeks after, and 6 weeks after treatment. Friedman analysis of variance was performed to compare the data from the parameters repeatedly measured in the inner-group analysis. Bonferroni correction was performed to compare between groups as a post hoc test if the variance analysis test result was significant. To detect the group differences, the Bonferroni Student t test was used. The Mann-Whitney U test was used to compare numeric data between the groups. In the exercise group, although no significant difference in FDI scores was noted between the start of treatment and week 3 (p < 0.05), significant improvement was observed at week 6 (p < 0.001). In the laser group, significant improvement in FDI scores relative to baseline was observed at 3 and 6 weeks (p < 0.001). Improvements in FDI scores were significantly greater at weeks 3 and 6 in the laser group than those in the exercise group (p < 0.05). Our findings indicate that combined treatment with low-level laser therapy (LLLT) and exercise therapy is associated with significant improvements in FDI when compared with exercise therapy alone.
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Affiliation(s)
- Banu Ordahan
- Department of Physical Medicine and Rehabilitation, Konya Education and Training Hospital, Yazırmah, Selçuklu, Konya, Turkey.
| | - Ali Yavuz Karahan
- Department of Physical Medicine and Rehabilitation, Konya Education and Training Hospital, Yazırmah, Selçuklu, Konya, Turkey
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Özçakar L, Akıncı A, Özgöçmen S, Aksu S, Çetin E. Bell's palsy as an early manifestation of acute lymphoblastic leukemia. Ann Hematol 2003; 82:124-126. [PMID: 12601494 DOI: 10.1007/s00277-002-0594-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2002] [Accepted: 11/05/2002] [Indexed: 11/28/2022]
Abstract
A 20-year-old man with the complaints of malaise, fever, and tooth gum bleeding presented at a hospital. He was found to have generalized lymphadenopathy, thrombocytopenia, and leukocytosis. Ensuing bone marrow biopsy led to a diagnosis of acute lymphoblastic leukemia (ALL). He also had a sense of "facial stretching" and difficulty during eating. After clinical examination, he was diagnosed with right-sided peripheral type facial nerve paralysis (Bell's palsy). The magnetic resonance imaging studies demonstrated bilateral facial nerve involvement, predominantly on the right side. The patient received steroid treatment and local facial radiotherapy for Bell's palsy. A concurrent facial exercise program was ordered. Seemingly a less significant diagnosis in a leukemia patient, we considered our case notable since an ALL patient presenting with Bell's palsy, especially at the very beginning of the disease, is not that common. The cases of relapsing ALL reported in the literature initially presenting with the same scenario further strengthen the significance.
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Affiliation(s)
- L Özçakar
- Department of Physical Medicine and Rehabilitation, Hacettepe University Medical School, Turkey
| | - A Akıncı
- Department of Physical Medicine and Rehabilitation, Hacettepe University Medical School, Turkey.
| | - S Özgöçmen
- Department of Physical Medicine and Rehabilitation, Fırat University Medical School, Elazığ, Turkey
| | - S Aksu
- Department of Internal Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - E Çetin
- Department of Radiation Oncology, Hacettepe University Medical School, Ankara, Turkey
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